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脊髓损伤患者压疮治疗后双侧坐骨缺损:病例报告

Bilateral Ischial Defect after Treatment of Pressure Ulcers in a Patient with Spinal CORD Injury: Case Report.

作者信息

Nariyama Akihiro, Kumegawa Shinji, Shimoe Takashi, Sakata Yasuhiro, Ueno Kazuki, Wada Yoshitaka, Asamura Shinichi

机构信息

Department of Plastic and Reconstructive Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.

Department of Plastic and Reconstructive Surgery, Wakayama Medical University, Wakayama, Japan.

出版信息

J Plast Reconstr Surg. 2024 Mar 1;3(3):128-133. doi: 10.53045/jprs.2023-0028. eCollection 2024 Jul 27.

Abstract

Pressure ulcers are extremely common in individuals with spinal cord injuries, especially ischial pressure ulcers, which have a higher rate of recurrence and are more difficult to treat than those in other regions of the body. We report a case of a 69-year-old man with bilateral ischial defects due to surgical treatment of pressure ulcers. Previous reports have shown that when surgical resection of pressure ulcers extends beyond the ischial tuberosity to the pubic symphysis and acetabulum, the superior psoas and piriformis muscles are easily dislocated, and the pelvic ring can be unstable. Therefore, the region of resection must not extend beyond the acetabulum and pubic symphysis to achieve a stable sitting position. In this article, we discuss an anatomically safe ischial tuberosity resection.

摘要

压疮在脊髓损伤患者中极为常见,尤其是坐骨压疮,其复发率更高,且比身体其他部位的压疮更难治疗。我们报告一例69岁男性因手术治疗压疮导致双侧坐骨缺损的病例。既往报道显示,当压疮的手术切除范围超出坐骨结节至耻骨联合和髋臼时,腰大肌和梨状肌容易脱位,骨盆环可能不稳定。因此,切除范围不得超出髋臼和耻骨联合,以实现稳定的坐姿。在本文中,我们讨论一种解剖学上安全的坐骨结节切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8bc/11912990/62695e131800/jprs-03-03-0128-g001.jpg

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